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RASCO COUNTY, FLORIDA <br /> Permit No, <br /> Date Permitted <br /> Builder Name/Owner Name Control#' ' <br /> County Parcel No, .3 2• 2_,5- 9,-1 (f B6 Q/?,,Qb 4%SubDIv: 0 <br /> Address/Location _��5b 5(7 &l'l1ll Zed, Ok.tpLe, <br /> ClassiftcatlonlType of Use <br /> TRANSPORTATION IMPACT FEE - Rate: Sq.Ft Unit: <br /> Exempt ❑Yes ❑.No How Determined <br /> Impact Fee Amount Zone No. TAM <br /> SCHOOL IMPACT FEE � <br /> Account (056) ,Single-Family Detached House Amount <br /> (057) Mobile,Nome <br /> (058) Other,Residential <br /> 123) Collection Fee <br /> Exempt ( Yes No How.Determined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit -Recreation Total <br /> Zone TOTAL AMOUNT $ 7 <br /> Exempt ❑Yes 0 No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt ❑Yes ❑ No How Determined Total Amount <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By �'T_ Checked By <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED-OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> BEEN PAID AND <br /> RECEIPTED'FOR BY A CENTRAL PERMITTING OFFICE-OF PASCO COUNTY <br /> Acknowledgement below does not Imply acceptance of concurrence,but simply receipt of a copy of this form,placing <br /> the building permit owner on nollca of this assessment and His c6nditlons of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />